It is easy to get confused between Medicare and Medigap. Both have the prefix “Medi” and both have different versions that are identified by letters such as Medicare part B or Medigap plan B. Let’s get it straightened out right here.
What is Medicare?
Medicare is Federally sponsored health insurance for people age 65 or older, or for people of any age that have certain disabilities. Medicare covers many health care products and services that are considered medically necessary, but there many things (gaps) that it does not cover. Medicare is divided into 4 sections or “parts” that cover many health care services and supplies. These parts are explained below.
The 4 Parts of Medicare
Medicare Part A
This is basic hospital insurance. It helps cover inpatient care in hospitals. It also covers the costs associated with skilled nursing facilities, hospice care, and even some home health care.
Medicare Part B
This is general medical insurance. It helps to cover many doctors’ services and outpatient care. It also helps to cover some costs associated with preventive care and services.
Medicare Part C
This is where you will find Medicare Advantage Plans. Advantage plans are Federally approved private health insurance options that include both Part A and B above and other additional costs such as prescription drugs. At one time Medicare Part C was a popular choice but with the addition of Medicare Part D, most people purchase go with Part A,B and D over Part C.
Medicare Part D
This is the most recent addition to Medicare. It’s the new Medicare prescription drug coverage option that is run by private insurance companies, but these plans are approved by and under contract with Medicare. This will cover some of the cost of prescription drugs.
If you understand the above, you have a pretty good understanding of Medicare. And it’s important to understand Medicare so that you can make a good, informed decision about purchasing Medigap insurance to fill in the gaps left by Medicare.
What is Medigap Insurance?
Medigap is a nickname for Medicare supplemental insurance plans. Medigap plans are private health insurance plans that are designed to help cover the “gaps” in coverage in Medicare. Examples of these gaps would be co-insurance, co-payments, deductibles and certain medical care not covered under Medicare. While Medigap does address many of the shortcomings of Medicare, Medigap plans currently sold do not cover long-term care, dental, vision or private nursing.
It’s also important to understand that Medigap policies are different from the Medicare Advantage Plans mentioned above. Medicare Advantage Plans are ways to get Medicare benefits, while Medigap plans are ways to get benefits that are not covered by original Medicare. Medigap plans supplement Medicare.
Medigap Plans are Standardized by the Federal Government
Even though Medigap plans are run by private companies such as Blue Cross or United Health, every Medigap policy must be standardized and must follow Federal and state laws. The Feds have labeled the different Medigap plans by letters “A” through “L.” There are multiple “A” plans offered by multiple companies, but they’re all basically the same plan. This makes it easy to compare “A” plans between two companies since they are the exact same coverage but not necessarily the same price. To clarify further still, that means that each private company that offers a certain plan has to offer the exact same benefits as their competition. The same can be said for the “B” plans, the “C” plans, and so on.